This story initially was revealed by Real Clear Wire
By Adam Andrzejewski
Actual Clear Wire
Topline: State governments spent $38.5 billion to extend Medicaid payouts in 2022, however there may be little oversight of how the cash is getting used, in line with a U.S. Government Accountability Office report.
Key info: Usually, state governments ship cash to Medicaid Managed Care, which pays healthcare facilities on behalf of sufferers as wanted.
However since 2017, states have been allowed to ship extra cash on to clinics to try to enhance the standard of healthcare. The follow was initially meant for use sparingly, nevertheless it’s turning into extra frequent.
State governments spent over $38.5 billion on these “directed payments” in 2022, that are managed by the Facilities for Medicare and Medicaid Providers.
However in line with the GAO, there are “weaknesses” in “CMS procedures for approving such payments.”
The report says that CMS has “weak fiscal guardrails,” that means states usually don’t preserve observe of whether or not a healthcare supplier is utilizing its funds successfully earlier than sending it more cash.
The GAO evaluated 5 states and located that none of them had been “consistently” evaluating whether or not the additional billions of {dollars} spent on Medicaid had been truly having an affect on affected person outcomes. In Texas, some hospitals obtained greater than double the usual quantity of funds, with little to no oversight.
The causes of this situation diversified. Some states had flawed information software program; some had been merely not “implementing best practices.”
CMS additionally has not set any clear limits on the amount of cash a single healthcare supplier can obtain.
Background: Eighteen states every spent over $500 million on directed funds in 2022, with California and Texas every giving out virtually $7 billion.
Many of the cash got here from taxes on non-public healthcare suppliers, whereas some got here from state basic funds and different sources.
America spent $804 billion on Medicaid total in 2022.
Abstract: States are gaining extra affect yearly over how Medicaid funds are dispersed, but they don’t have sufficient methods in place to stop potential wasteful spending.
The #WasteOfTheDay is delivered to you by the forensic auditors at OpenTheBooks.com
This text was initially revealed by RealClearInvestigations and made accessible through RealClearWire.
